Severe Autoimmune Cytopenias in Treatment-Naive Hepatitis C Virus Infection

To determine the clinical characteristics and outcome of patients with chronic hepatitis C virus (HCV) infection presenting severe autoimmune cytopenia unrelated to interferon α therapy, we analyzed characteristics and outcomes of 35 patients with HCV (16 from our departments and 19 from the literature). We considered active autoimmune hemolytic anemia (AHA) as a decrease of at least 2 g/dL in hemoglobin levels, an increase of at least 0.6 mg/dL in the serum unconjugated bilirubin level, a reticulocyte count >5, and a positive direct Coombs test. Severe neutropenia was defined as a neutrophil count <0.5 × 109/L, and severe thrombocytopenia as a platelet count <30 × 109/L.